NPI | 1568835007 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 006692) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MA PA5554) |
Enumeration Date | 2015-11-05 |
Last Update Date | 2025-02-13 |